Uruguay goalkeeper Sergio Rochet saved Ismaël Koné's weak penalty kick after the shooter's stutter step on Canada's third attempt and Alphonso Davies put Canada's fifth and final kick off the crossbar.
Federico Valverde, Rodrigo Bentancur, Giorgian de Arrascaeta and Suárez converted Uruguay's attempts past goalkeeper Dayne St. Clair while Jonathan David, Moïse Bombito and Mathieu Choinière made their kicks for Canada, which went first in the shootout.
Bentancur hada put Uruguay ahead in the eighth minute but Canada built a 2-1 lead on goals by Koné in the 22nd and David in the 80th.
The 37-year-old Suárez, Uruguay's career scoring leader, got his 69th international goal on a quick attack following a centering pass from José Giménez.
St. Clair was given an unusual yellow card as Rochet was preparing for Bombito's penalty kick, possibly for trying to distract the goalkeeper.
Saturday's play-off game in Charlotte was played on the same field where Uruguay players entered the stands and fought with Colombia fans following a 1-0 semi-final loss on Wednesday night.
This game was much more subdued than the heated semi-final, with an announced attendance of 24,386, compared to more than 70,000 - the overwhelming majority rooting on Colombia - on Wednesday night.
Defending champion Argentina and Lionel Messi play Colombia for the title on Sunday night at Miami Gardens, Florida.
Argentina and Uruguay are tied for the most Copa titles with 15 each.
Canada, who hired American Jesse Marsch as coach in May, will consider the tournament one of their best performances since winning the 2000 CONCACAF Gold Cup. The Canadians reached the World Cup for the second time in 2022, the first since 1986.
Canada made six changes for their starting semi-final lineup and Uruguay made two. Davies, Canada's top player, entered in the 62nd minute after leaving the semi-final with a leg injury.
Uruguay went ahead when Sebastián Cáceres headed a corner kick to Bentancur, who took a touch and spun as Luc de Fougerolles reacted slowly, then kicked the ball over St. Clair for his third international goal and his second of the tournament.
Canada tied the score 14 minute when Bombito won a header duel with José María Giménez and the ball popped up toward goal, and Koné's bicycle kick went over Rochet for his third international goal.
Facundo Pellistri slid the ball past St. Clair in the 23rd minute but was ruled offside.
Canada went ahead when Rochet parried Koné's initial shot and the rebound went to David, who tucked a right-foot shot shot just inside a post for his 28th international goal.
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